Healthcare Provider Details

I. General information

NPI: 1669583001
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date: 05/12/2023
Reactivation Date: 06/02/2023

III. Provider practice location address

721 N. LASALLE STREET
CHICAGO IL
60654
US

IV. Provider business mailing address

721 N. LASALLE ST. BILLING DEPARTMENT
CHICAGO IL
60654
US

V. Phone/Fax

Practice location:
  • Phone: 312-655-7725
  • Fax: 312-236-5384
Mailing address:
  • Phone: 312-655-7725
  • Fax: 312-236-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA KUEVER
Title or Position: EXECUTIVE DIRECTOR-CATHOLIC CHARITI
Credential:
Phone: 312-655-7222